Investigation of the Preferred PT-PTA Relationship in a 2:2 Clinical Education Model
Mathews, Harvey, Smith, Shelby, Hussey, James, Plack, Margaret M., Journal of Physical Therapy Education
Background and Purpose. Inadequate education of PTs and PTAs on the roles and preferred relationship of the PT and PTA has been identified over the past 2 decades. Components of the "preferred" relationship have been acknowledged but not validated. This report was designed to (1) validate the content of a survey to assess participant perceptions of the roles, practices, education, and preferred relationship of the PT and PTA; (2) assess the outcomes of a shared PT and PTA clinical experience model designed to enhance the preferred PT-PTA relationship, and (3) assess participants' perceptions of the shared clinical experience.
Case Description. A multistep process employing 3 key informants and 14 panel jurors was used to develop and validate a survey on the roles, practices, education, and preferred relationship of the PT and PTA. Four participants completed a 4-week shared clinical education experience designed to promote collaboration between PT and PTA students. Prior to this experience, participants were instructed on the role of the PT and PTA as defined by CAPTE accreditation criteria and South Carolina law. To assess the outcomes of this model, participants completed a written test of knowledge, a survey on practice, and summative reflective essays.
Outcomes. According to the survey, participants agreed with 13/18 preferred practice concepts, 3/7 opinions on current practice, and 0/5 opinions on educational training. The greatest inconsistency noted was related to discharge documentation. Participants also noted that this experience enhanced the student PTs' ability to write a plan of care inclusive of the PTA and the students' collaboration and delegation skills and it also provided insight into current clinical practices.
Discussion and Concluson. Further research is needed to determine the influence of (1) accreditation criteria, (2) APTA standards, and (3) state laws on the preferred PT and PTA relationship. Clinical education models designed to increase student focus on PT and PTA interactions may enhance the skills needed to facilitate a preferred PT-PTA relationship.
Key Words: Preferred relationship, Clinical education, Survey, Content validity.
BACKGROUND AND PURPOSE
During the past 20 years, several authors have noted misperceptions regarding the delineation of roles among both physical therapists (PTs) and physical therapist assistants (PTAs) that may have impeded a preferred PT-PTA relationship.1-5 More than 50% of PTs surveyed in 1986 and 1992 reported that "no information was provided on the role of the PTA in their professional education program."3(P571) Current research is sparse on the knowledge and attitudes of PT and PTA practitioners and students regarding the legal roles, education requirements, and optimal interaction of PTs and PTAs, particularly in the clinical setting.1 While the Commission on Accreditation in Physical Therapy Education (CAPTE) and the American Physical Therapy Association (APTA) have described a "preferred" PT-PTA relationship, practitioner agreement with the elements of this relationship have not been examined or validated.6,7
Studies from the 1990s indicate that the perceptions of both PTs and PTAs on the proper role of the PTA were often erroneous.3,4 Physical therapists were noted to adopt either a restrictive or permissive stance relative to the role of the PTA.3,8 For example, in one study, 35% of PT respondents thought it was acceptable for PTAs to complete specific manual muscle testing at a time when CAPTE did not list this task as an appropriate data collection skill for PTAs.3 Similarly, several years later, it was noted that 21% of PTs reported that it was appropriate to delegate evaluation of sensory systems and posture and determination of short- and long-term goals to PTAs,8 which is another example of inappropriate utilization of PTAs.
Much like the PTs, PTAs varied from being overly restrictive to overly permissive in interpretations of their job role. …